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[Acute disseminated encephalomyelitis (ADEM) onset during meningitis and sepsis]

Hachiro Ohnishi1, Yasunori Sawayama, Iwao Ariyama

  • 1Department of Environmental Medicine and Infectious Disease, Faculity of Medical Sciences, Kyushu University.

Kansenshogaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
|October 31, 2007
PubMed

Insights

This case study highlights a patient initially diagnosed with bacterial meningitis who later developed acute disseminated encephalomyelitis (ADEM). Prompt steroid treatment successfully resolved ADEM symptoms and brain lesions.

Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Bacterial meningitis can present with symptoms like fever, headache, and stiff neck.
  • Early antibiotic and corticosteroid treatment is standard for suspected meningitis.

Observation:

  • A patient initially treated for Streptococcus pneumoniae meningitis showed clinical improvement but neurological deterioration.
  • Brain MRI revealed white matter lesions consistent with ADEM, not typical of initial meningitis.

Findings:

  • Acute disseminated encephalomyelitis (ADEM) was diagnosed based on clinical progression and MRI findings.
  • High-dose steroid pulse therapy led to rapid resolution of neurological symptoms and MRI lesions.

Implications:

  • This case underscores the importance of considering ADEM in meningitis patients with atypical neurological decline.
  • Early recognition and treatment of ADEM with corticosteroids are crucial for favorable outcomes.

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